Surprise Medical Billing

You slip and fall getting out of your car and twist your ankle badly. So you go to the emergency room, get an X-ray, and good news: it turns out the bone is not broken.

You’ve got a bad sprain and just need ice and rest. It was a bad day, but it could have been worse, and fortunately, you have health insurance. The hospital is in your network, and you only had a co-pay. But wait a minute: when the bill comes, there’s a $500 charge for radiology? What’s radiology? And how did that charge get on your bill? Why, with your health insurance coverage, do you have this bill?

It turns out the radiologist who read your X-ray was not in your health insurance network. It wasn’t your fault, and you had no way to know that – no one even asked you. It’s just the kind of surprise you don’t want.

At the same time, your hospital is doing their best with limited resources. Your care is their highest priority. There are hundreds of health insurance plans, and the hospital staff may not have been provided the latest information about which radiologist, pathologist, or anesthesiologist is in a particular insurance plan. It’s a complex problem, and it creates unnecessary cost and expense. That’s why, together with Consumers for Affordable Health Care and Rep. Bob Foley (R-Wells), I submitted legislation that won’t allow surprise medical billing. This legislation was signed into law by Governor LePage, and will go into effect soon. Your health insurer and your care provider will be required to communicate more frequently, update their provider directories, and protect you so the maximum you will pay is your in-network rate.

Have you been affected by a surprise medical bill? I’d love to hear your story.